Staying Well Nourished through Cancer Treatment

by Jeannine B. Mills, MS, RD, CSO, LD

The nutritional well-being of
cancer survivors can be significantly
challenged by cancer
treatment. Nutritional goals for most
people facing cancer treatment include
maintaining a healthy weight, optimizing
calorie needs, minimizing vitamin
and mineral deficiencies, and managing
treatment-related side effects. Evidence
shows that those who are able to maintain
a healthy weight and optimize
calorie intake during treatment will have
an improved response to treatment, enhanced
recovery, and a better quality
of life.

Just as there are many different
cancer-treatment strategies, so are there
different recommendations for getting
adequate nutrition during cancer. Nutritional
goals vary according to cancer
type, treatment, weight, age, and preexisting
conditions, such as diabetes.
Some cancer treatments cause more
nutrition-related side effects than others.
While some people are at higher risk for
losing weight while on treatment, others
may be at risk for weight gain. Moreover,
cancer-related side effects, such as poor
appetite, taste changes, nausea or vomiting,
diarrhea or constipation, mouth
sores, or discomfort with swallowing,
can hinder you from getting the nutrition
you need.

If your appetite has decreased, try eating small meals or
snacks every two hours and drink calorie-rich liquids.

Jeannine Mills

Poor Appetite
If you have a poor
appetite, getting adequate nutrition can
be especially challenging. Poor appetite
may be a result of pain, fatigue, nausea,
taste changes, alteration in bowels, or
depression. Often, the anxiety associated
with the cancer diagnosis itself can also
affect your appetite. If your appetite
has decreased, try eating small meals
or snacks every two hours and drink
calorie-rich liquids. Focus on condensed
calories in smaller servings, such as
cheese, dried fruit, nuts, avocados,
bananas, full fat or two percent fat dairy
products, pasta, dense breads, and pretzels.
Try to avoid unnecessary diet
restrictions, and cater to your taste
preferences.

Taste Changes
Taste changes can occur
even before cancer treatment begins.
Foods may have less taste or no taste at
all, or foods may have an unappealing
flavor. Texture of foods and liquids may
also lose their appeal. This can drive
you to not want to eat at all. Cleansing
your palate with a non-alcoholic mouth
rinse or a baking soda and salt rinse
before eating may be helpful.

Bitter and sour flavors may be more
appealing when your sense of salt is enhanced
or when your sense of sweet is
diminished. Try different types of vinegar
doused onto vegetables; chutney
as a side to meat dishes; marinades for
meat or vegetables; salsa added to meals;
capers or olives added to salads; cilantro,
fresh basil, or arugula added to a
mix of salad greens; lemon squeezed
onto vegetables or fish; citrus added to
seltzer or
water; and different
fruit
juices. Foods
that are warm
and moist may
also be more
appealing, as
dry mouth may
be to blame
for your taste
changes.

Nausea
With or without vomiting,
nausea can be a significant barrier to
eating. Medication to ease your nausea
should be the first step in managing this
side effect. Some foods may be better
tolerated than others when nausea is a
problem. For example, foods that are
cool or room temperature may be easier
to tolerate, as they don’t give off as strong
an odor as warm or heated foods. You
may also want to avoid overly sweet,
fried, or spicy foods when you are experiencing
nausea.

Constipation
Cancer treatment or
medications given to manage treatment-related
side effects, including pain
medications and some anti-nausea medications,
can cause constipation. Some
medications, like narcotics, can slow the
normal action of the stomach. Even if
you’re consuming less food than usual,
it’s important to continue to try to move
your bowels daily or every other day to
help avoid constipation.

Staying well hydrated is an important
part of managing constipation.
A high-fiber diet is often encouraged,
and sometimes a daily laxative or stool
softener is recommended, but you should
first talk with your doctor to determine
the best approach for you.

Maintaining a healthy weight, meeting
your calorie and protein needs, avoiding
micronutrient deficiencies, and managing
treatment-related side effects are
important components of your cancer
care. Meeting these nutritional goals
can help you respond and recover more
completely from treatment and avoid
treatment delays. For further guidance,
see a registered dietitian.

♦ ♦ ♦ ♦ ♦

Jeannine Mills is a certified specialist in
oncology nutrition and a clinical dietitian
at the cancer center at Dartmouth Hitchcock
Medical Center in Lebanon, NH.
She is also an active member of the Oncology
Nutrition Dietetic Practice Group
of the Academy of Nutrition and Dietetics
(oncologynutrition.org).

This article was published in Coping® with Cancer magazine,
November/December
2012.